Figure 2.

Figures from Grillo, describing the technique. Epidermis that is circumscribed as a pedicled flap and inverted over the tracheal opening is highlighted in blue. A, Location of pedicled peristomal skin flap, anterior view. B, Axial view of tracheal defect; dashed lines indicate lateral boundaries of skin flap, which will be incised. C, Axial view, with lateral edges of skin flap liberated from surrounding tissue, ready to be brought together over the defect. D, Edges of skin flap are brought together with absorbable suture. E, Final closure, with epidermis that was originally facing outward, now inverted, and providing closure over the tracheal defect.